Influence of Echocardiographic Guidance on Positioning of the Buttoned Occluder for Transcatheter Closure of Atrial Septal Defects

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Abstract
Ideal position of the buttoned device for occlusion of atrial septal defects was achieved more often with transesophageal than with transthoracic echocardiographic guidance (10/11 vs 7/23; P = 0.001). Patients with ideal device position were less likely to have residual shunts, device unbuttoning, or atrioventricular valve regurgitation (2/17 vs 11/17; P = 0.002). We therefore recommend the use of transesophageal echocardiography to guide implantation of the buttoned device.